Seòmar agus comataidhean

NHS National Services Scotland manages the contract for high secure services in Scotland on behalf of NHS Scotland.

The State Hospital, Carstairs stopped admitting female patients in 2008. The costs for female patients treated in high secure services in England are only available from 2011-12 and are as follows:

We are working with NHS boards to deliver commitment 12 of the Mental Health Strategy to reduce admissions of under 18s to adult wards, with a new commitment to reduce figures across Scotland to a figure linked to current performance in the South of Scotland area during delivery of the strategy timeframe 2012-15. To support this we have:

Made a significant investment (£13.5 million from 2009 to 2014) to deliver faster access to specialist child and adolescent mental health services in the community; and in the CAMHS workforce which has seen the overall clinical workforce increase by 44% since 2008.

We have with ISD and the CAMHS regional tier 4 network, developed a data set to track progress in developing intensive community treatment teams and how the adolescent inpatient units are working. We are continuing to work with the CAMHS regional tier 4 networks to ensure that tier 4 services for children and young people are operating effectively and safely.

To meet the needs of children and adolescents, the North of Scotland are building a new 12 bed inpatient unit to replace the current 6 bed unit. This will increase the national bed base from 42 to 48 beds, and improve the quality of the estate.

There are some reasons why it may not always be possible for a young person to be admitted to a specialist child and adolescent bed, for example, a crisis admission out of hours where there are concerns for the young person’s safety, or where a specialist facility might be a considerable distance from family support that could help recovery.

In relation to the NHS, the testing, diagnosis and treatment of people with hepatitis C has been a Government priority since the publication of the Hepatitis C Phase 2 Action Plan in 2008. This priority is maintained in the Sexual Health and Blood Borne Virus Framework, which specifically requires multi-agency partners in local areas to work together to deliver local strategies on early diagnosis and treatment of those infected.

As a result of the government’s investment in these activities the cumulative number of individuals diagnosed with hepatitis C, and not known to have died, has increased from 18,638 in 2007, to 29,952 in 2013. Likewise the number of people commencing hepatitis C therapy every year has more than doubled from fewer than 500 per year to over 1,000 per year.

In relation to alcohol and drug partnerships (ADPS) the Scottish Government has worked in partnership with ADPs to strengthen governance and accountability arrangements and to develop and agree a set of core ADP outcomes and indicators. One of the national indicators that ADPs are expected to report against on an annual basis is the prevalence of hepatitis C among people who inject drugs. It is expected that ADPs will already be providing this information to their local community planning partnerships.

A confidential blood borne virus service, incorporating hepatitis C, is available to all prisoners within the Scottish Prison Service. This service includes immunisations, testing and counselling, treatment and harm reduction awareness-raising. Around 580 prisoners have been tested for hepatitis C every year since 2010. The Sexual Health and Blood Borne Virus Framework highlights the importance of ensuring that around 10% of those initiated onto treatment every year are prisoners. This target has been met, with more than 10% of all treatment initiations in Scotland taking place in prison every year since 2009-10.

The Sexual Health and Blood Borne Virus Framework sets out five high level outcomes the government wishes to see delivered. To support monitoring of progress against these outcomes the frameworks includes a range of detailed data indicators. When the current framework comes to an end in 2015, the Scottish Government will produce a report evaluating the progress made under the framework, based on these key indicators as well as reports on progress from NHS boards and other partners.

With access to NHS dental services improving it is appropriate for NHS Dumfries and Galloway to review their service provision in order to ensure routine dental care is provided by independent contractors where possible.

It is recognised that some patients with complex treatment needs are not able to be seen by independent contractors. Patients with additional dental support needs in Dumfries and Galloway have typically been seen, and will continue to be seen, by the Public Dental Service at Dumfries Dental Centre and Galloway Community Hospital.

In the course of developing the Hepatitis C Phase 1 Action Plan, Health Protection Scotland estimated the costs of the current and future burden of chronic hepatitis C disease on the NHS in Scotland. This work was completed in February 2007.

Health Protection Scotland estimated that the annual health service costs associated with the monitoring, management and treatment of people with diagnosed chronic hepatitis C disease in Scotland was £11.8 million in 2005. This figure included £2.8 million for antiviral therapy for hepatitis C.

The same work also estimated potential future costs, assuming uptake of hepatitis C antiviral therapy by around 1,000 former injecting drug users a year. In this scenario it was estimated that costs would rise to around £22 million in 2015, comprising around £13 million for the costs associated with the management of chronic hepatitis C disease and around £9 million for the costs of antiviral therapy. (These costs do not take account of inflation and were calculated based on 2005 prices).

A study led by the University of the West of Scotland and published in 2012 (Hepatitis C Prevalence and Incidence among Scottish Prisoners and Staff Views of its Management, Taylor et al), included an assessment of awareness raising activities within Scottish prisons. The study reported that a confidential blood borne virus service, incorporating hepatitis C (HCV), is available to all prisoners within the Scottish Prison Service. This service includes immunisations, HCV testing and counselling, HCV treatment and harm reduction awareness-raising such as awareness sessions regarding HCV (and other BBV) risk behaviour awareness training

The report also concluded that the Scottish Prison Service “is to be congratulated for having introduced a comprehensive range of interventions…. designed to reduce injecting, prevent transmission of infection and provide treatment, care and support for those already infected with HCV.”

The majority of prisoners at risk of hepatitis C infection within Scottish prisons are people who inject drugs (PWID) carrying out short sentences and who may also have been made aware of HCV through community based awareness programmes.

Table 1 and 2 provide available data for liver-related deaths among those diagnosed with hepatitis C in Scotland, and by age group, for the period 2007 to 2012. Data on age-standardised deaths from hepatitis C, and by parliamentary constituency is not available. Data for 2012 are provisional as they are not yet published.

Table 1: Number of liver-related deaths* among those diagnosed with hepatitis C in Scotland each year 2007-2013

* Deaths were defined as related to liver disease if the underlying cause of death was either (a) viral hepatitis, (b) liver cancer, (c) alcoholic liver disease or (d) non-alcoholic liver disease, or the contributing cause of death was either (b), (c) or (d).

** Data for this year are provisional.

Table 2: Number of liver-related deaths* among those diagnosed with hepatitis C in Scotland each year 2007-2013, by age group

The decision by the Chief Dental Officer was based on a request by NHS Highland to recruit a fixed term vacant salaried dentist post. This decision has no bearing on the Scottish Government’s long term commitment to NHS dental services in Skye.

NHS Highland is currently formalising a strategy for primary care dental services. Recruitment to a fixed term post at this stage will provide flexibility in terms of planning.

There is no programme on studying screening for hearing loss jointly funded by the Medical Research Council (MRC) and the Chief Scientist Office (CSO).

The MRC and CSO jointly fund the Scottish Section of the Institute of Hearing Research which is located at the Glasgow Royal Infirmary. CSO funding for the institute is currently £368,172 per annum.